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Would Restalyne be a good alternative to botox around the eyes? (Photo)

I no longer use botox because I'm very sensitive to it. I've had as little as 3 units under each eye, which looks great on day 1 & 2 but as the botox takes more effect, my eyes look dead and lifeless. Botox also makes the skin on the sides of my eyes look hollow due to lack of using the muscle in that area. If I dont smile big, I don't have wrinkles but when I do smile big, the skin on the sides of my right eye seems to bunch up. Would restalyne be a good filler around my eye?

Doctor Answers (11)

Restylane for Crow's Feet?

+3
Hi Kimberrr.  Botox is not commonly used under the eyes.  It's not a great product there because when it relaxes the muscle at the lower lid and can look saggy or bunchy.  So little needs to be used to avoid this issue that it is not a very effective solution for wrinkles below the eyes.  Instead, use Restylane under the eyes and Dysport (Botox) at the outer eye - crow's feet.

If you draw a 45 degree angle from your pupil toward your cheek, the area below this line is for filler and the area above the line is for Dysport.  Based on the photo it appears that most of the issue would be for Dysport at the crow's feet.  

In any event, most practitioners would not suggest filler for the crow's feet because the issue is related more so to muscle contraction than to dermal fillers.  You can view photos of our patient Dysport treatments for this area at the link below. 


Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Restalyne be a good alternative to botox around the eyes?

+2
 If you do not want BOTOX than I might use Belotero Balance instead of Restylane. But that is me. I prefer a easier injectable with longer lasting results.// 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Botox and fillers

+2
Thank you for your question. Botox is not intended to be used for injection in the lower eyelids. I would recommend using botox for the forehead, crow's feet, and the glabella.  I would also be cautious about using fillers around your eyes. I would find a board certified plastic surgeon in your area and request a consult. They will be able to give you some options to help achieve the look you want. Good luck.

Arun Rao, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 5 reviews

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Difference between Botox and Fillers

+2
Botox and Fillers are completely different. Botox weakens muscles, so it is useful for wrinkles that are caused by muscle action, such as frown lines and crows feet.  Fillers fill up things and are used to treat hollow areas, such as tear troughs (under eye hollows), cheeks, etc.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Would Restalyne be a good alternative to botox around the eyes?

+2
You could use Restylane or Belotero or Juvederm Ultra in this area. However, the lines that you see are the result of muscle contraction meaning that Botox is typically the best option there. Filler will plump any imprinted lines. The two issues with this are that filler won't diminish the underlying cause of the lines and filler can result in a ridge replacing a fine line. It can be done but you'll want to seek a highly experienced injector. If it doesn't turn out the way you like, the filler can be dissolved but your injector should discuss the risk of a less than ideal result prior to injection. I hope this information is helpful.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Wrinkles around the eyes

+2
Usually a filler such as restylane is used to soften undereye wrinkles (or those around the eyes) caused by volume loss with Botox used to soften dynamic wrinkles caused by using muscles in that area.  It would be best for you to consult with a board certified specialist who can help guide you as to what would be best for you.

For who don't respond to botox or don't like using it, there is now an FDA-approved procedure that mimics the effects of Botox in the glabella without using botox.  Please consult with a board certified specialist who can assist you with achieving the goals you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

The aging lower eyelid, multiple problems, multiple solutions

+2
Several things happen in the lower eyelid/crow's feet area as we age.  Unfortunately, each one responds best to a different solution or fix.  Dynamic wrinkling when we smile or animate responds best to Botox or other agents like Dysport or Xeomin.  This is mostly used in the crows feet area but occasionally in very small doses for bunching up just below the eyelashes as well.  Fixed wrinkles in the crow's feet and crepiness in the lower lid respond best to peeling -laser peels, chemical peels or nonablative fractional resurfacing are typically used.  Depressions of the tear trough and some depression and creasing  in the lower lid can be treated with hyaluronate fillers like restylane, belotero and juvederm. 

Lawrence Bass, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 8 reviews

Restylane vs Botox for crow's feet

+2
It is usually not ideal to put Restylane or any other filler into the crow's feet area. If you don't want to have Botox or Dysport there, you could possibly have a fractional treatment like the Invasix Fractora just to this area. This treatment is awesome for small areas like that.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.5 out of 5 stars 7 reviews

Botox relaxes muscles and Restylane is a filler. Both could be helpful.

+2
If you have hollow tear troughs under your eyes and also crows-feet wrinkles to the side of your eyes, you would benefit from both Restylane and Botox.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.5 out of 5 stars 9 reviews

Restylane around eyes

+1
Restylane can be used "off label", meaning that it is not specifically FDA approved to enhance the tear trough area.  It does not work well for fine lines around the eyes.  I think Botox Cosmetic is a better option.  You might also consider using a topical prescription retinoid such as tretinoin.  This can help stimulate your natural collagen production to diminish the appearance of fine lines.

Jerome Potozkin, MD
Danville Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.